Growing up in a ex-soviet country, "sugar rush" wasn't a thing. In fact, when I was a kid, sugar water was given to children to get them to calm down. It wasn't until recently that it's become a term here, probably introduced from US media.
Sucrose is considered a mild analgesic for infants under 18 months
More broadly: The human nervous system undergoes a lot of changes during maturation. As an example, some NMDA receptors in the prefrontal cortex become inhibitory during puberty whereas they were previously excitatory. Essentially a polarity switch in the some of the reasoning centers of the brain.
Very broadly, and to get my super asshole-y pedantic Socratic hat on: What is pain anyway? Like, if you can't remember it, is that even pain? What does it mean to 'remember'? Can a grasshopper or a yeast cell feel 'pain' if it doesn't have consciousness? Is an infant really conscious? What does it mean to feel something anyway? Are feelings even 'real'? How the fuck do we even know anything really anyway?
This is, again, super pedantic Socratic asshole philosophy bullshit, but it does end up mattering in the context of infants. And, also, to be super clear here, I'm not advocating for causing pain to infants here.
My heart broke in so many ways when I had to put my child through tongue tie release surgery.
Yes most people I talked to, professionals included, answered "they won't remember", which to me felt like the most dystopian answer of all.
As if the problem with pain is the memory of it.
The short term effect of pain is that it is unpleasant. There is no need to appeal to long term effects when someone is clearly suffering right there and then.
So by your logic, why should I work if I suffer at work? There are plenty of longterm factors and trade offs to consider. Temporary pain shouldn't be avoided as much as it is today.
You shouldn't suffer at work if you can work without suffering.
This sounds like I'm being pedantic because no one would never be in favor of suffering for no benefit, I'm arguing against a strawman.
But in the context of babies suffering, it might surprise you to learn that doctors used to give zero thought to their suffering at all, believing that they don't become conscious until they grow a little. Apparently when they screamed in pain it was like a mechanical autonomous response to a stimulus, not real human pain.
They weren't just being sadists. Applying anesthesia is always risky and if you can get away with not doing it then it's sometimes worth engaging in a bit of rationalization to ease the conscience.
> The short term effect of pain is that it is unpleasant. There is no need to appeal to long term effects when someone is clearly suffering right there and then.
There is also the fact that trauma is a thing that's not deeply researched, we don't know if pain trauma in babies could affect them later in life.
If there are any effects, they aren't readily noticeable in existing populations. Even 15 minutes after the procedure there are usually no issues.
So by your logic, why should I work if I suffer at work? There are plenty of longterm factors and trade offs to consider. Temporary pain shouldn't be avoided as much as it is today.
We aren't talking about any type of population, we are talking about children 0-1 year. There is very little research on how pain affects the development of humans at this stage because as you might guess, it's incredibly hard to do any sort of test. When humans are this young, small changes could affect how they evolve.
Short-term pain should be evaluated as something that could have long-term effect on a baby and weighted against the value that the surgery is going to bring, which is why is very disappointing to hear from a professional "they will not remember it" which implies a "why should you care", that's extremely bad.
Short-term pain is still pain and a human being is there, suffering, how could you not consider that for a surgery. Adults ask for anesthesia because are scared of short-term pain, the epidural is highly requested by all mothers giving birth, but babies having laser surgery aren't given anything more than tylenol (I understand why, but still), of course they are in very intense pain. How could we not consider that?
And that's overlooking the fact that after tongue tie release, the surgery spot must be rubbed for a minute (with oil) to prevent the tissue from regenerating, 4 times per day, for 15 days (I did this). So it's not really "short".
"We aren't talking about any type of population, we are talking about children 0-1 year."
Sure, you have the circumcised vs uncircumcised populations as the most prominent groups for long term observation.
"There is very little research on how pain affects the development of humans at this stage"
This isn't true. There is a fair amount of research on Pubmed. The general concensus is that repeated pain can have developmental impacts, but that one-off pain generally does not.
"I understand why"
It doesn't sound that way.
"How could we not consider that?"
I'm not saying it shouldn't be considered. It's simply not a significant enough factor to sway most decisions.
The rubbing with oil part is general uncomfortable but not nearly on the level of pain that the studies I've seen are finding to be a problem (eepeat surgeries, repetitive needles, etc).
> "I understand why"
> It doesn't sound that way.
There are only a handful of medications tested on infants and that are safe on them. It's pretty easy to understand since every medication is for "12 years+" essentially
> I'm not saying it shouldn't be considered. It's simply not a significant enough factor to sway most decisions.
I don't think that's the case. If a medium discomfort is being addressed, pain could sway to the "no procedure" option. If we are talking about a high discomfort, sure like you said, it doesn't sway.
Not only that, but it's on the parent to make the call, not on the professional.
The parents are making the call based in the benefits (perceived or real) and the risks. There is no objective benefit to the use of anesthesia at that age and the risks of use are significant. So it's all about the other risk/rewards of the procedure. Temporary pain is not a real factor.
FWIW, there's a lot of disagreement over how efficacious a tongue-tie release is, how it should be done, and who should do it, with a bit of a turf battle between pediatricians, ENTs (ear/nose/throat specialists), and dentists, and lactation consultants throwing fuel and misinformation onto the pile. Dentists tend to favor a laser tongue-tie release, while ENTs and pediatricians do it the old fashion way with scissors. Supposedly pediatricians often do a shallower cut that doesn't fully release the webbing. The practice in general has been relatively controversial. [1][2]
Personally, all 3 of my kids had tongue ties, as do I (one common type of tongue-tie is an autosomal dominant trait, meaning you have a 50% chance of passing it down to your kids with one copy, 100% with two). When I was a kid, tongue-tie surgeries were not really a thing, and my mom was never informed about it. But then, I have a speech impediment that might be related to it. My oldest kid had his released by an ENT at ~1 month (no anesthetic), my middle kid by a pediatrician at 2 days (sugar water, and possibly an incomplete release), and my youngest had to have his released by two different ENTs because the first didn't fully release the tongue (first was no anesthetic, the second used lidocaine).
We noticed an immediate improvement in breastfeeding with the first and he has no speech problems, the second never had any breastfeeding difficulties but has a slight speech impediment, and the third has seen zero improvement in breastfeeding (according to my wife at least...personally I think he's a bit less gassy) but at least has full range of motion with the tongue after the second procedure. Recovery was quick with the first 3 procedures but sucked with the 4th - he didn't want to eat for a good 12 hours afterwards.
All the ENTs and pediatricians we talked to said there's no special care required and you don't need to massage the mouth. Many of the lactation consultants we've met with say you do. Both groups are fond of throwing shade on each other. Personally we didn't do any special exercises and got good results with 2 out of the 3 kids.
I think it's really one of those cases where a parent needs to read all the evidence for and against and make a judgment call, and then it may or may not work. But then, many things in life are like that as well.
I had only one experience and it was positive. My daughter (oldest) had both tongue and lip tie, we went with the dentist and laser. Our lactation consultant spotted the lip/tongue tie, but she was able to get occasional proper breastfeeding position.
My wife's breasts were destroyed by day 3 though, she couldn't breastfeed anymore, so at roughly 1 month after trying many alternatives we went with the release.
It was incredibly painful to do and it was devastating for me to rub over the wounds for 15 days, but the results were great, there was immediate improvement in breastfeeding, no pain anymore. After 1 week my wife's breasts were recovering and my daughter has no speech impediment and was breastfed for 2 years on demand.
Still, I would have punched the dentist in the face when he said "she won't remember". The only person with empathy was the lactation consultant.
For what is worth, our lactation consultant provided high quality information and was the only person who was able to consistently get my wife to breastfeed properly while the tie was up. At the hospital they did a check as if it was a checkmark on a piece of paper (which probably was).
This can be empathy - reassuring you that the procedure won't have any memorable negative impact. If you say you know that they don't use anesthesia dusnto the risks, then the fact that the pain isn't memorable is the best possible outcome.
I have no doubt that was the best possible outcome, that's why we committed to it.
But I don't agree on using "she won't remember" as a sign of empathy. That's an excuse. You could do horrible things to babies based on that.
There are various resources for parents to help children deal with vaccination and one of the common thing is to never mention the pain, so using the won't remember excuse won't fly.
Same here in South America. We even give children coffee and it causes no apparent issues. Admittedly this coffee is taken with lots of milk, but even that is only because children don't like the bitter taste. Over-stimulation was never even a consideration.
I thought sugar rushes was a culture-bound syndrome in which children in the US go hyperactive and other children do not. From the article, it seems like it's something even more mundane than that, and children in the US never got hyperactive from sugar at all.
My experience with my two kids and observing other children tends to lean this way, though I'm leery of accepting social science results that confirm my biases [1]. That sugar rushes exist is very much conventional wisdom, but I've seen any number of cases where a parent says something like "wow, so-and-so is going crazy; did they have any sugar" with "no" -> "I guess it's a mystery" and "yes" -> "oh, of course". Not definitive, but it's a similar experience I've seen with people who are critical of women drivers -- when someone drives badly, and it turns out to be a woman, the reaction is "of course" and when it's not, it is just ignored.
I've had innumerable low-key evenings where children have had chocolate cake or candy before bedtime and were fine; and similarly healthy nights where they were going wild. Of course I've seen the opposite as well; just mostly uncorrelated to the food. I think if there is an effect it is probably smaller than conventionally believed.
[1] The only thing I'm more leery of is social science results that contradict my biases
Your anecdata matches mine. I tried to reason with other parents that there were too many confounding factors to assign sugar poisoning as the cause for hyperactivity, but it fell on deaf ears because they just knew.
Of course, a right thing to do is to avoid giving our children any substance to which that poison has been unnaturally added...
In those party circumstance drinks containing caffeine (energy, coke) are often consumed by kids. Those drinks usually also contain lots of sugar which is known by the people. It could be that the "sugar rush" rather comes from the caffeine than the sugar, but the people put it on the sugar.
I haven't noticed sugar rush being a thing. What I do see is sugar addiction though: the more refined sugar they get, the more they ask. We have to do cleanup weeks to reset that.
Also everybody seems ok giving constantly sugar to children. (multiple times per day)
The consistency of sugar isn't the problem, many cultures use sugar to balance meals and therefore make them taste better. This is often how those cultures get kids used to eating a variety of veggies that Americans would quite literally throw up at the sight of.
The problem is the large quantity in one sitting, especially in the morning. It's juice and french toast and maple syrup. It's cereal and milk. It's pancakes and whipped cream. It's granola bars and juice. Everything standardized as breakfast is too much sugar with not much of anything else, and most parents don't really think twice about it. More parents would quite literally be better off just giving their kids one of those premade protein shakes in the morning. At least they would get some protein with the sugar.
I've heard before that there's no such thing as a sugar rush. I've been careful to observe my own children's reactions to sugar.
My conclusion is that it doesn't affect their behavior much during the day. However, if they have sugar closer to bedtime, it seems to inhibit their desire to go to bed. They start acting like overtired children which can look similar to a sugar rush.
We also don't make it a habit of giving our kids sugar close to bedtime, so there could still be bias because I'm observing situations the kids are staying up late and consuming sugar.
I've always heard that it's more likely certain additives, preservatives, and food colorings are what cause hyper activity and that a lot of sugary things contain these and could be responsible in part. There is a lot of absolutely insane "foods" out there that if possible it's probably best to not give children. Hyper activity is the least of my concerns, personally.
But sugar is still considered unhealthy to give to children on a regular basis. Given how much the water is mudded by a lot of talks, and that parents are always confused what treat to give/promise to their children...
> Given how much the water is mudded by a lot of talks, and that parents are always confused what treat to give/promise to their children...
No, don't trail off, what's the end of that sentence? "...we should lie to them and support this misconception so they'll do an unrelated thing we think is healthy"?
An MD of my acquaintance said that what parents imagine to be a sugar rush is actually the effect of caffeine in coffee. I had always heard that sugar is if anything soporific.
Question: Why are you linking and summarizing an article that happens to have the word sugar in it but that is barely related to the subject? (second question: Are you a human?)
Sorry what? This is just out of the realm of plausibility.
There's a reason why academics no longer use sugar-pills as placebo, because sugar has immediate psychological effects.
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Edit: Just read it, the blog author doesn't understand statistics.
"—Sixteen reports met the inclusion criteria for a total of 23 within-subject design studies. The weighted mean effect size and related statistics for each of the 14 measurement constructs revealed that although the range for these means was from -0.14 for direct observations and up to +0.30 for academic tests, the 95% confidence interval for all 14 mean effect sizes included 0."
So there's a world of difference between "The studies didn't prove X" and "The studies proved X is not true."
To illustrate - I could do a study right now on myself about whether getting hit on the head reduces IQ, and odds are, I wouldn't have enough data to prove anything. Doesn't mean I proved the opposite.
Also, if the article wasn't paywalled I'd be curious how many grams of sugar were given etc, but probably not even worth my time. I also think that a placebo of artificial sweetener is dubious unless we are sure those can't cause behavior changes too.
You may find the results surprising, but there is plenty of experimental evidence that sugar rushes, as popularly conceived, simply don’t occur in children.
Google ‘No such thing as a sugar rush’ to get a feel for how long this has been studied.
I can’t find anything to suggest that sugar pills were dropped as a placebo because of sugar’s effects.
Well if there is plenty of evidence, perhaps it should be linked here rather than this relatively weak meta-study that confuses the absence of evidence with the evidence of absence.
After a short google search I am not seeing information that sugar is no longer used for placebos.
It's also already established knowledge that 'sugar makes kids hyper' is urban myth; this specific phenomenon is used as an example by countless psychology and epistemology university textbooks.
If you tell parents that their kids have had sugar, they will report those children as behaving hyperactively whether they've actually had sugar or not. It's a consistent outcome.
It's one of those things that you can't convince people of because there's some things they have a deep need to "know."
Other things that you can't convince people of: the caffeine levels in coffee don't really keep people awake (they'll still stay up if you slip them decaf), and that there never were any significant numbers of people putting razor blades in Halloween apples (other than parents looking for attention.)
yes, you're right about that being a misinterpretation of 'could not reject the null hypothesis'.
i couldn't get the full text of the meta-analysis, but i've read similar studies in the past and one critical effect was that parent's ratings about perceived hyperactivity were heavily affected by whether the parent thought their child received sugar but there was no effect detected based on whether the children actually received sugar.
so it doesn't completely rule out whether sugar has an effect, but it does show that parental 'hyperactivity detectors' are broken and will be biased based on whether they think their kid had sugar (so you and everybody else should look at your anecdotal expereience with suspicion)
> but it does show that parental 'hyperactivity detectors' are broken
I'll grant that some are for sure. But it doesn't mean other parents can't quietly and effectively notice their children's responses to various foods.
Frankly any sort of research on behaviors imo should eventually move to scoring by completely objective measures (e.g. computer assessment of whether they can watch a screen for 30 seconds and how often they look away, or whether they can read a paragraph)
> Russell's teapot is an analogy, formulated by the philosopher Bertrand Russell (1872–1970), to illustrate that the philosophic burden of proof lies upon a person making empirically unfalsifiable claims, as opposed to shifting the burden of disproof to others.
> Russell specifically applied his analogy in the context of religion.[1] He wrote that if he were to assert, without offering proof, that a teapot, too small to be seen by telescopes, orbits the Sun somewhere in space between the Earth and Mars, he could not expect anyone to believe him solely because his assertion could not be proven wrong.
What you would do is you would have a higher standard of proof. If you conduct a study with a 95% confidence interval that sugar doesn't increase excitement more than 5% then, you can say with 95% confidence the mean falls above that 5% threshold.
However in this study, that confidence intervals were all over the place (from huge effect on mood to negative effect on mood) which generally means you need more participants to conclude anything.
Thanks for this. I will take it into account when I give some sugar to my child in the evening. I really "can see" that she has need to put out this sugar which sometimes she gets by running left and right, doing super energetic things, and if put to bed, she'll just randomly rotate for another hour. Usually it's been associated with an occasion, but recently I gave her something like a milk but with tons of sugar before sleep, and she was rolling in bed like a drill, and there was no special occasion or events that day...
Yeah, I've had this conversation with a friend who has a kid about the same age as mine. He swears that there's no such thing as a sugar rush, whereas I absolutely see it in my kid and there's nothing you can tell me to make me think otherwise.
As far as I can tell, the difference in our opinion comes down to general diet - his kid has a sweet cereal for breakfast and generally has a high sugar diet, whereas my kid absolutely does not. She has a single small sweetie at the end of the day after dinner.
Any time she gets spoiled (by someone else!) I can see her eyes widen and her energy levels go up and her behaviour become more bouncy and erratic about 10-20 minutes after consumption, lasting another 20-40 minutes thereafter.
Perhaps its genes or something else too, but I swear to god it's not simply 'confirmation bias'.
People in South America have never seen sugar rushes in real life, and every single child is given sugar every day. A common breakfast and afternoon snack includes coffee(!) with lots of milk and sugar.
If genes were involved we would expect the prevalence to be different, but there is no way that not a single South American child has the right genes for sugar rush.
Yes, that's the point i was making - kids who have lots of sugar don't seem to be affected, as it's just their baseline, whereas kids who don't have a lot of sugar do seem to exhibit it.
Curiously, my friend's partner's Argentinian, so... .
It might depend on how literally you mean "have lots of sugar".
If the dominant component really is physicalist/biological then things that actually contain sugar but don't look like they contain sugar will cause sugar rushes. For example fruit juice, ketchup, pizza.
If it's cultural/psychological then only things that are "sugar-coded" will produce the effect. Like candy, syrup, ice cream, soft drinks.
If you feel like doing some mad science, see if you can give your kids a rush using sugar-free coke or something like that.
Sadly, I've informed my daughter that she can't have coke until she's 22 :)
Also, I'm 'one of those' and avoid sugar-free alternatives.
For sure though, I can't say I've much noticed it in the likes of fruit smoothies and such, nor when she has a lollypop or some other sugar-laden thing that takes time to consume.
But if she’s being spoiled then isn’t she in a situation in which she’d probably be excited anyway? At a party or grandmas house or wherever novel situation it is in which she is getting an unusual treat?
in the name of science, you could get gel caps, fill some of them with sugar and some with something else, say, xylitol, have someone else blind you so you don't know which is which and just test it for months and see what happens.
How can people be so disconnected that they believe some paper on the internet over their own bodies? Try drinking a big glass of fruit juice and observing that:
- there's a near-immediate "up" effect
- that's stronger the less sugar/carbs you've ingested recently
- consuming a lot of refined sugar traps you in a up/crash cycle that looks a lot like (a milder version of) drug dependence
It's because personal experience lies to you a lot. People are garbage at consistently and accurately recalling events over time unless they're taking notes about what's happening and reviewing those. It's also important to note what the studies are actually looking at, it isn't saying there's no energy boost but that there's no effect on "children’s behavior or cognition" people misremember and misattribute things all the time so it's important to study things scientifically it's the whole reason we use the technique.
We can't measure everything. Self-reporting + averaging misses subtle results, or even regular-sized results looked at the wrong way.
There's also the secondary layer - people are social creatures, and adjust our behavior to match what is allowed or expected.
The scientific system is designed for inanimate objects that function the same way every time. Why is it so hard to believe that the test is flawed, not the experience?
> Why is it so hard to believe that the test is flawed, not the experience?
It's multiple tests performed multiple ways by different people thinking about how to adapt to the issues that trying to measure people poses. That's far more convincing to me than adhoc non rigorous common knowledge. We're so beset by failures in our ability to draw good conclusions from non rigorous anecdata, confirmation bias, selection bias, hidden factors, faulty recall, etc, that I'm really hard pressed to believe anecdotal data when it contradicts multiple studies.
Does higher blood sugar make someone feel higher energy? If we can solve that problem, we can likely answer the question about children using logic rather than subjectives.
Yes, if you are hungry and eat sugar, it metabolizes fast and you will be more active. That is not sugar high, that is how you should be all the time, you was just numbed by hunger.
With things like this, we trust papers over ourselves because of confirmation bias and the placebo effect. The sugar rush in particular is very culturally prominent, so the seeds of that bias are well-planted in all of us.
Arguing against that principle is arguing for pseudo-science: “Acupuncture works, I tried it!,” “Crystal-healing works, I tried it! Don’t trust a paper over your own body!”
I've never experienced an "up" effective from fruit juice. Never as a child nor as an adult.
I presume it's because I never had that cultural expectation. I never heard of any of this "sugar rush" nonsense before I had access to the Internet, which wasn't until my late teens.
This is really weird. It's something I feel as an adult when I consume too many sugary things.
Could it be related to something else in those sugary things (candy, sodas, ..) instead of sugar? That'd be interesting to find out.
That's the part I say went out of fashion. The scientific consensus used to be that a stimulus can subconsciously influence you for a while. Like if you saw an ad targeted towards old people you'd subconsciously fix your posture and walk with a straighter back for a little while after you saw the ad.
Those studies failed to replicate, but some people still believe in them because they are so intuitive, they seem to match their personal experiences. Like seeing kids go hyperactive after eating candy because candy reminds them of Christmas and Halloween and birthday parties and other occasions in which they are allowed to play and be noisy.
